By Dr. Liji Thomas, MDAug 8 2022Reviewed by Aimee Molineux Much research has gone into controlling or dampening the social and economic effects of the coronavirus disease 2019 pandemic.
A recent paper describes the use of aprotinin, a protease inhibitor that works across several pathways, to reduce the severity of the condition. The authors of the current study conducted a phase III trial called TAC . It demonstrated the safety and efficacy of nebulized aprotinin in moderate COVID-19, leading to better clinical outcomes with inhaled aprotinin in moderate COVID-19 patients hospitalized with pneumonia. These patients required less supplemental oxygen and their treatment period was lower than the control group, which received a placebo.
In the previous study, the researchers could not measure the viral load in all patients. The present study, published online in the European Journal of Clinical Investigation, set out to measure the reduction in viral load in the preserved tracheobronchial samples from a group of moderately ill COVID-19 patients, which would indicate its ability to prevent the progression of the disease as well as treat severe cases.
While the PCR results were similar between groups at baseline, the viral loads dropped significantly in the group treated with aprotinin. Moreover, the aprotinin group had a shorter treatment period overall, at 5.5 days vs. 7.4 days, respectively. Aprotinin prevents thrombosis and inflammation via its effects on the host proteases and coagulation regulators like kallikreins, which are activated by SARS-CoV-2 capsid proteins. The former prevents SARS-CoV-2 activation and cell entry, and replication within the host cells.
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